The Observer: Flattening the curve or fattening it?

By Ron McAllister

Wednesday

May 13, 2020 at 2:00 AM

We have been hearing for weeks about flattening the curve of infections from COVID-19. We’ve all seen the bell curve suggesting the height and the breadth of the virus’s reach. Most people probably understand that we must reduce the height of the curve to prevent medical resources and health infrastructure from being overwhelmed. If everyone gets sick at the same time, hospitals will be unable to cope, so we must flatten the curve.

What seems less well understood is that pushing down the number of cases at any one moment does not mean that we will necessarily reduce the overall number of infections. That normal bell-shaped curve is like a water balloon. Press it down and it flows forward in time. I’m not arguing that we should ignore flattening; far from it. We have to flatten the curve to prevent overwhelming the health system. We have to flatten it so that people with everyday non-corona diseases can still be treated.

What I am saying, however, is that flattening the curve will lead to fattening it. Flat or fat, the number of cases will be more or less the same because the virus is not going to disappear any time soon. We still don’t know if the virus is seasonal. Many experts are warning that COVID-19 could have multiple peaks. That curve will rise and fall more than once in 2020 and beyond. If it comes back in autumn to coincide with seasonal influenza, the second spike may be worse than the first.

Further, if people do not follow the guidelines for masking, social distancing and limiting contact, we could see a worst case scenario: fattening the curve without flattening it. This would result in a prolonged flood of hospitalized COVID-19 cases. The most recent estimates from FEMA and the CDC suggest that May is a critical month. In the absence of continued precautions, the number of new cases in the country will soar by summer. The average number of daily deaths will increase by more than 70%, to 3,000 fatalities per day. COVID-19 planning from the White House must account for this reality. If people give up on their precautions now, there will be more cases for a longer time.

Some have argued that the virus is not that severe and that the cure is worse than the disease. In truth, we don’t yet know how severe it is. Dr. Anthony Fauci notes that a 1% mortality rate would make COVID-19 ten times more lethal than the seasonal flu. It also would mean that, if just a third of the population contracted it over the next year and 1% died as a result, more than a million deaths would occur and many millions of victims would be hospitalized.

The only way to eliminate the health threat posed by this pandemic is widespread immunity. Herd immunity means that people will be protected because either: 1) enough patients have contracted and recovered from the disease — though we don’t yet know whether you can get it twice — or 2) enough people get vaccinated to prevent the virus from sickening them. Of course, there is as yet no vaccine.

Our fearless leader says that we will have a vaccine by the end of the year. This is wishful thinking. Vaccines can take years to develop. Look at the polio vaccine, which was mass tested more than 60 years ago. Poliomyelitis had caused untold damage for decades before Dr. Jonas Salk succeeded in 1954 with a vaccine.

Vaccines have saved a lot of unnecessary suffering from polio, measles, mumps, rubella, tetanus, pertussis, diphtheria, pneumonia and other diseases. Public health has dramatically improved during my lifetime because of vaccines and because of general improvements in hygiene. COVID-19 is teaching us lessons we learned and forgot in the last century, e.g., wash your hands! The next few weeks could offer more lessons — especially if we drop our guard and the infection surges.

People are restless under the restrictions, the social distancing, the masking, the quarantining. I get that, but we should not lose sight of the fact that we must flatten the curve and stretch out the incidence long enough for herd immunity to develop — one way or the other.

Given a choice between contracting COVID-19 and being vaccinated against it, I know what I’d prefer. Hit me with your best shot! I’m waiting ... in isolation.

Ron McAllister is a sociologist and writer who lives in York.

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